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Experts urge longer care, better services to ease opiate crisis

LAURA KRANTZ, VTDigger.org

Posted:
01/16/2014 01:00:00 AM EST

Less than a week after Gov. Peter Shumlin caught the nation's attention with a speech about Vermont's opiate addiction "crisis," addiction treatment professionals told lawmakers the largest need is for services that help people stay drug-free after detox.

Outpatient services

The director of an opiate treatment center Tuesday afternoon urged the House Human Services Committee to spend $100,000 leftover from this year's budget on outpatient services. Another director, of a network of recovery centers statewide, said they need more money to help people stay drug-free for life.

The committee plans to decide Wednesday morning how the money can be best spent and make a recommendation to the House Appropriations Committee for the Budget Adjustment Act. The money is left over from a plan that fell through to expand the Maple Leaf Farm residential drug treatment center in Underhill. The center recently laid off eight employees.

Young said the biggest need is for outpatient services, which are more substantial than a once-a-week AA meeting but typically happen after a patient has finished receiving live-in treatment. When people walk out the door of Maple Leaf Farm or another residency program, Young said, they should be monitored. Maple Leaf Farm director Bill Young Tuesday addressed the committee as one of three speakers who tried to describe what the state's landscape of addiction treatment and recovery services looks like every day at ground level.

"That's where the most needy people are," he said.

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The committee also heard from Jack Duffy, executive director of Valley Vista, a 78-bed inpatient drug and alcohol treatment center in Bradford. He told the lawmakers his facility is struggling on several fronts.

First, the center is wrestling with a new state policy that makes it harder for patients to stay longer than 15 days in treatment. The average stay in past years was between 28 and 35 days, Duffy said, but implementation in July of the managed Medicare program requires that staff ask permission from the state to keep patients longer than 15 days.

Because people leave before they are ready, recidivism rates have doubled, Duffy said.

"We're not getting the outcomes that we would like or that we have in the past," he told lawmakers.

Technical glitches have prevented his center, and others, from receiving Medicaid reimbursements, and the state hasn't raised rates since 2010, Duffy said.

Young, of Maple Leaf Farm, said more important than the shorter stays is the need for people to have a plan in place for when they leave live-in treatment.

Last to speak was Mark Ames, network coordinator for the Vermont Recovery Network, 11 centers across the state that provide ongoing help to people after they have received treatment.

The network served more people this year than last but for the third year in a row has had a slowly decreasing number of volunteers. That is mainly because the centers can't pay for volunteer coordinators to manage them, Ames said.

At the same time, recovery centers are becoming a first step for addicts who want to recover, in addition to being a place for them to turn after treatment.

"Recovery centers are turning in to the front door for the treatment system - and the back door," he said.

If awarded money, Ames said it would go not to hire volunteers but staff who are trained to make sure the centers remain a safe environment where recovering people feel comfortable.

In a phone interview after the hearing, Young emphasized that whatever paths lawmakers take to address shortcomings of the state's opiate addiction recovery system, nothing will be a quick fix.

"We're talking about a major problem in the state that requires a long-term effort. You do not fix these issues in one year," Young said. But he added that improving the situation was possible.

"We're a small state and if we put our minds to it, we can make major change."

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